The ratio of male to female is relatively large. Methods of plastic surgery for male and female degeneration: It mainly includes penis and testis excision, urethral displacement, artificial vagina shaping, facial bone feminization surgery such as breast augmentation shaping and nose shaping, chin shaping, zygomatic cheek shaping, thyroid cartilage reduction shaping, tone adjustment, electrolysis or surgical hair removal and other additional operations and treatments. Of course, not every patient needs to do all the above operations, and usually several operations are selected according to the actual situation. Methods of operation: 1, penis orchiectomy, urethral transposition, artificial vagina and vulvoplasty: the patient took the lithotomy position of bladder and performed the operation under general or epidural anesthesia. (1) Suprapubic cystostomy, sterile urine bag and catheterization. ⑵ Formation of scrotum and penis flaps. ⑶ Excision of testis and epididymis. Anatomy and excision of bilateral testis and epididymis. ⑷ The urethral cavernous body was separated, and a long enough urethra was reserved for reduction. (5) Reconstruction of clitoris with island partial glans flap pedicled with neurovascular. [6] Cavernectomy. Once the vagina is reconstructed. (8) Reconstruction and shaping of female vulva. Levies iodoform gauze strips are filled in the vagina, and the dressing in the operation area is shaped and bandaged. 2, breast augmentation, silicone prosthesis implantation: male and female transsexuals, less breast tissue, wide chest, so generally choose a larger breast prosthesis. The incision was designed in the anterior axillary fold to cover the postoperative scar. The prosthesis was implanted under the pectoralis major muscle. The operation steps are basically the same as those of female breast augmentation. 3. Feminization of facial contour: After the whole facial design is completed, it will be gradually carried out: forehead plastic surgery, nose plastic surgery, chin plastic, cheekbone cheek plastic surgery and other facial bones and soft tissues feminization. 4. Thyroid cartilage reduction and plastic surgery: an incision was designed at the transverse skin of mandibular neck and separated subcutaneously. After the thyroid cartilage was fully exposed, the most prominent part of the wing plate of the thyroid cartilage on both sides (that is, the Adam's apple) was exposed, which was removed and the incision was sutured in layers.